{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:04:53Z","timestamp":1792159493379,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Insomnia predicts the onset of depression, commonly co\u2010presents with depression and often persists following depression remission. However, these conditions can be challenging to treat concurrently using depression\u2010specific therapies. Cognitive behavioural therapy for insomnia may be an appropriate treatment to improve both insomnia and depressive symptoms. We examined the effects of a fully\u2010automated digital cognitive behavioural therapy intervention for insomnia (\n                    <jats:italic>Sleepio<\/jats:italic>\n                    ) on insomnia and depressive symptoms, and the mediating role of sleep improvement on depressive symptoms in participants from two randomized controlled trials of digital cognitive behavioural therapy for insomnia. We also explored potential moderators of intervention effects. All participants met criteria for probable insomnia disorder and had clinically significant depressive symptomatology (PHQ\u20109\u00a0\u2265\u00a010;\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a03,352). Individuals allocated to treatment in both trials were provided access to digital cognitive behavioural therapy. Digital cognitive behavioural therapy significantly improved insomnia (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a0.001;\n                    <jats:italic>g<\/jats:italic>\n                    \u00a0=\u00a00.76) and depressive symptoms (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a0.001;\n                    <jats:italic>g<\/jats:italic>\n                    \u00a0=\u00a00.48) at post\u2010intervention (weeks 8\u201310), and increased the odds (OR\u00a0=\u00a02.9; 95% CI\u00a0=\u00a02.34, 3.65) of clinically significant improvement in depressive symptoms (PHQ\u20109\u00a0&lt;\u00a010). Improvements in insomnia symptoms at mid\u2010intervention mediated 87% of the effects on depressive symptoms at post\u2010intervention. No variables moderated effectiveness outcomes, suggesting generalizability of these findings. Our results suggest that effects of digital cognitive behavioural therapy for insomnia extend to depressive symptoms in those with clinically significant depressive symptomatology. Insomnia may, therefore, be an important therapeutic target to assist management of depressive symptoms.\n                  <\/jats:p>","DOI":"10.1111\/jsr.13140","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T16:14:02Z","timestamp":1598544842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Insomnia as a mediating therapeutic target for depressive symptoms: A sub\u2010analysis of participant data from two large randomized controlled trials of a digital sleep intervention"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2217-3052","authenticated-orcid":false,"given":"Alasdair L.","family":"Henry","sequence":"first","affiliation":[{"name":"Big Health Inc. San Francisco California USA"},{"name":"Sleep and Circadian Neuroscience Institute Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2936-7717","authenticated-orcid":false,"given":"Christopher B.","family":"Miller","sequence":"additional","affiliation":[{"name":"Big Health Inc. San Francisco California USA"},{"name":"Sleep and Circadian Neuroscience Institute Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Emsley","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Informatics Institute of Psychiatry, Psychology and Neuroscience King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryony","family":"Sheaves","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7517-197X","authenticated-orcid":false,"given":"Annemarie I.","family":"Luik","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Erasmus MC University Medical Centre Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna L.","family":"Littlewood","sequence":"additional","affiliation":[{"name":"NIHR Greater Manchester Patient Safety Translational Research Centre University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate E. A.","family":"Saunders","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C.","family":"Kanady","sequence":"additional","affiliation":[{"name":"Big Health Inc. San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna R.","family":"Carl","sequence":"additional","affiliation":[{"name":"Big Health Inc. San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Davis","sequence":"additional","affiliation":[{"name":"Big Health Inc. San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon D.","family":"Kyle","sequence":"additional","affiliation":[{"name":"Sleep and Circadian Neuroscience Institute Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin A.","family":"Espie","sequence":"additional","affiliation":[{"name":"Big Health Inc. San Francisco California USA"},{"name":"Sleep and Circadian Neuroscience Institute Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.01.011"},{"issue":"1","key":"e_1_2_8_3_1","first-page":"29","article-title":"Cognitive models of depression","volume":"14","author":"Beck A. 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